西吡氯铵与聚维酮碘含漱液对口腔假丝酵母菌属感染的疗效

目的探讨西吡氯铵与聚维酮碘含漱液对口腔假丝酵母菌属感染患者的临床治疗效果。方法选取2011年1月-2012年12月100例口腔假丝酵母菌属感染患者为研究对象,将其按照随机数字法分为对照组和观察组,对照组给予聚维酮碘含漱液治疗,观察组给予西吡氯铵含漱液治疗,均治疗两周,观察两组的临床治疗效果,所有检测数据采用SPSS19.0软件进行统计分析。结果临床治疗总有效率观察组为96.0%、对照组为74.0%,两组总有效率比较差异有统计学意义(P<0.05);对照组和观察组治疗前真菌镜检阳性率分别为70.0%、72.0%,治疗后阳性率分别为40.0%、28.0%,两组比较差异有统计学意义(P<0.05)。结论临床中口腔假丝酵母菌属感染患者应用西吡氯铵含漱液的治疗效果明显优于聚维酮碘含漱液的治疗效果,能够有效的缓解患者的临床症状,并对真菌的清除效果更强,治疗安全性高,值得临床应用与推广。     

两种泡腾消毒剂的消毒效果及对化脓性伤口作用的临床观察

目的 考察聚维酮碘泡腾滴丸和醋酸氯己定泡腾滴丸体内外消毒效果,为临床消毒剂的选择应用提供依据.方法 制备金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌、白色假丝酵母菌菌悬液,蛋白胨生理盐水为中和剂,用中和剂载体定量试验考察观察中和剂及其使用浓度适宜性,用悬液定量杀菌试验考察泡腾滴丸溶液对这些细菌的体外杀灭作用;选取93例外伤化脓病例,随机分组,常规治疗为对照,观察泡腾滴丸溶液促进伤口愈合的作用.结果 含0.1％有效碘或0.1％氯己定的泡腾滴丸溶液能在1 min内有效杀灭金黄色葡萄球菌和大肠埃希菌,在2 min内有效杀灭铜绿假单胞菌和白色假丝酵母菌,对化脓性外伤的治疗作用也与对照组相当.结论 聚维酮碘泡腾滴丸和醋酸氯己定泡腾滴丸是方便实用的消毒制剂.     

西帕依固龈液联合西吡氯铵治疗患者口腔假丝酵母菌属感染的疗效研究

目的探讨西帕依固龈液联合西吡氯铵治疗患者口腔假丝酵母菌属感染的疗效,为治疗口腔感染提供参考依据。方法选取2011年1月-2015年5月收治的92例口腔假丝酵母菌属感染患者,采用随机数字表法分为观察组和对照组,每组各46例;两组患者均给予常规抗真菌处理,西吡氯铵含漱液漱口,观察组在此基础上采用西帕依固龈液漱口,治疗30d后进行疗效评价,数据采用SPSS 20.0软件进行统计分析。结果 92例口腔假丝酵母菌属感染患者共分离出108株假丝酵母菌属,其中72例患者分离单一菌株,以白色假丝酵母菌为主,占62.96%;治疗后,观察组和对照组患者总有效率分别为97.83%和80.43%,两组比较差异有统计学意义(P<0.05);两组患者口腔疼痛、黏膜萎缩和黏膜红斑评分均显著降低(P<0.05),且观察组显著低于对照组(P<0.05)。结论西帕依固龈液联合西吡氯铵治疗口腔假丝酵母菌属感染,可有效缓解患者口腔疼痛、黏膜萎缩和黏膜红斑等症状,效果优于单用西吡氯铵治疗。     

西吡氯铵含漱液与西帕依固龈液联合使用对口腔假丝酵母感染治疗的研究

目的研究含漱西吡氯铵对口腔假丝酵母感染患者的治疗效果和西吡氯铵与西帕依固龈液联合使用对口腔假丝酵母菌感染患者的治疗效果。方法选取2014年12月-2016年12月在医院接受治疗的口腔假丝酵母感染患者225例,分为试验组113例和对照组112例,试验组采用西吡氯铵与西帕依固龈液联合使用,对照组采用含漱西吡氯铵;观察两组患者治疗前后临床症状的改善情况、红斑黏膜和口腔疼痛评分的改善情况及患者经治疗后的疗效。结果治疗后,两组患者口腔真菌清除效果,差异无统计学意义;治疗后,试验组红斑黏膜评分和口腔疼痛评分分别为(0.45±0.12)分和(0.44±0.17)分低于对照组(0.91±0.19)分和(0.95±0.21)分,两组红斑黏膜评分和口腔疼痛评分比治疗前降低(P均0.05)。两组菌落数均减少,但差异无统计学意义;两组患者口腔真菌清除效果,差异无统计学意义。结论西吡氯铵与西帕依固龈液联合使用在一定程度可有效清除口腔假丝酵母,改善患者临床症状,缓解患者痛苦。     

不同护理液对减少口腔颌面外科患者手术部位感染的作用

目的 口腔颌面外科患者术后手术部位感染(SSI)中选择最有效的口腔护理液,以预防口腔手术部位感染.方法 1293例口腔内无感染灶的患者随机分为A、B、C、D4组,A组329例用生理盐水、B组317例用0.02％呋喃西林、C组298例用0.1％聚维酮碘、D组349例用0.12％醋酸氯己定进行术前含漱,术后口内冲洗,无植入物者术后观察并随访1个月,有植入物者术后观察并随访1年,比较手术部位感染发生情况.结果 A组发生SSI 16例,感染率为4.86％,B组发生SSI 19例,感染率为6.00％,C组发生SSI 5例,感染率为1.68％,D组发生SSI5例,感染率为1.43％,与采用生理盐水组的患者比较,呋喃西林漱洗组发生的SSI差异无统计学意义;聚维酮碘、醋酸氯己定漱洗组发生的SSI更低(P＜0.05);聚维酮碘和醋酸氯己定与呋喃西林比较,聚维酮碘和醋酸氯己定组发生的SSI更低(P＜0.05);聚维酮碘与醋酸氯己定比较,发生的SSI差异无统计学意义;而聚维酮碘、醋酸氯己定在预防和控制口腔颌面外科患者术后SSI发生比生理盐水和呋哺西林效果更好.结论 0.1％聚维酮碘、0.12％醋酸氯己定更能降低口腔颌面外科患者的手术部位感染发生率.     

西吡氯铵与聚维酮碘含漱液对口腔念珠菌感染的疗效及安全性对比

目的对比研究西吡氯铵与聚维酮碘含漱液治疗口腔念珠菌感染的应用价值。方法将74例口腔念珠菌感染患者随机分为两组各37例。观察组给予西吡氯铵含漱液治疗,对照组给予聚维酮碘含漱液治疗。记录两组患者治疗前后的口腔红斑、粘膜萎缩以及疼痛症状评分,并对比两组患者的临床疗效和不良反应发生率。结果治疗前,两组红斑、粘膜萎缩以及口腔疼痛等症状评分相比差异不显著(P>0.05)。治疗后,两组患者以上指标均显著改善,且观察组改善程度优于对照组,差异具有统计学意义(P<0.05)。观察组的总有效率为97.3%,高于对照组的78.4%,不良反应发生率为2.7%,低于对照组的21.6%,差异均具有统计学意义(P<0.05)。结论西吡氯铵用于治疗口腔念珠菌感染的疗效优于聚维酮碘,能有效改善患者口腔症状,不良反应少,值得临床推广。     

复方氯己定含漱液对消化系统肿瘤患者围手术期口腔内环境的影响

目的探讨复方氯己定含漱液对消化系统肿瘤患者围手术期口腔内环境的影响。方法选取2017年1月至12月在南通市第三人民医院普外科行消化系统肿瘤手术的患者116例为研究对象,其中2017年1月至6月收治的59例纳入对照组,2017年7月至12月收治的57例纳入试验组。对照组患者于术后第1天开始使用复方氯己定含漱液,试验组患者于入院当天开始使用复方氯己定含漱液。分别对两组患者在入院含漱前、术前30 min、术后回室准确测定其口腔异味程度、咽拭子试验、口腔p H值,比较两组患者口腔异味程度、咽拭子培养菌落数及口腔p H值。结果试验组患者咽拭子培养菌落数在术前30 min、术后回室均低于对照组,两组比较差异具有统计学意义(P0. 01);含漱后试验组与对照组相比,其口腔异味程度有所下降,但比较显示差异无统计学意义(P0. 05);两组患者口腔p H值在入院含漱前、术前30 min、术后回室相比差异均无统计学意义(P0. 05)。结论在消化系统肿瘤患者围手术期使用复方氯己定含漱液,并掌握正确有效的含漱方法可以减少患者的口腔菌落数,减轻口腔异味,从而促进患者舒适,但含漱时间的长短对于口腔p H值的影响不大。     

呼吸机相关性肺炎病原菌耐药性分析及口腔消毒对感染预防价值

目的 探讨呼吸机相关性肺炎(VAP)的病原菌分布及其耐药性特点,并观察复方氯己定含漱液进行口腔消毒处理对VAP的预防效果.方法 选择45例确诊为VAP患者作为研究对象,采集痰培养进行检测,对分离的菌株进行鉴定,采用K-B法对其耐药性进行检测,另分别选取53例及62例进行呼吸机治疗的ICU住院患者,分别设为对照组及干预组,干预组在呼吸机治疗前采用复方氯己定含漱液对口腔进行消毒,观察并比较两组患者VAP的发病率、气道细菌检出率、发热及咳嗽天数等临床指标.结果 共检出病原菌83株,其中革兰阴性菌55株占66.27％,革兰阳性菌17株占20.48％,真菌11株占13.25％;前3位病原菌为铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球菌,分别占18.07％、15.66％、14.58％;铜绿假单胞菌对多种抗菌药物产生耐药,对亚胺培南及美罗培南敏感率均为100.00％;金黄色葡萄球菌也对多种常用抗菌药物产生一定的耐药,但尚未发现耐万古霉素及呋喃妥因菌株;白色假丝酵母菌对两性霉素B敏感率为100.00％;采用复方氯己定含漱液进行口腔消毒干预后,ICU住院患者VAP发病率及气道细菌检出率分别为6.45％、9.68％,均显著降低,发热天数(3.14±1.07)d及咳嗽天数(3.28±1.17)d均显著缩短.结论 VAP感染病原菌以革兰阴性菌为主,对多种抗菌药物产生耐药,治疗前进行口腔消毒干预可有效预防VAP的发生.     

两种含漱液治疗复发性口腔溃疡的临床观察

目的：对比益口含漱液和复方氯己定含漱液治疗复发性口腔溃疡的临床效果。方法：120例复发性口腔溃疡患者被分为益口含漱液试验组（60例）和复方氯己定含漱液对照组（60例）,并对两组疗效进行比较。结果：益口含漱液组总有效率（76.67%）明显高于复方氯己定含漱液对照组（43.33%）,两者有显著性差异。结论：益口含漱液因含有三氯新、茶多酚、甘草甜素、维生素E等多种有效成分,对复发性口腔溃疡有良好治疗效果。     

白色假丝酵母菌对常用消毒剂抗力的观察

目的了解常用3种消毒剂聚维酮碘、手消毒剂、氯氧三嗪(三氯异氰尿酸)泡腾片对医院感染白色假丝酵母菌与标准菌株的杀灭效果是否存在差异,临床株对这3种消毒剂是否产生抗力。方法用肉汤稀释法进行最低抑菌浓度(MIC)及最小杀菌浓度(MBC)测定,采用悬液定量杀菌试验了解消毒剂对细菌的杀灭率。结果聚维酮碘对8株临床分离的白色假丝酵母菌和标准株的MIC、MBC有所不同,而手消毒剂、氯氧三嗪泡腾片则差异无统计学意义;100mg/L聚维酮碘、1/16手消毒剂、250mg/L氯氧三嗪泡腾片对标准株和8株临床株作用10min的杀灭率均达100%。结论 8株临床分离的白色假丝酵母菌对聚维酮碘的抗力有所不同,但未检测到对手消毒剂、氯氧三嗪泡腾片产生抗力的临床株;在临床应用中,适当的延长消毒剂的作用时间可以达到杀灭白色假丝酵母菌的效果。     

采取综合干预措施可降低口腔癌患者术后下呼吸道感染率

目的探讨综合干预措施对降低口腔癌患者术后下呼吸道感染的效果。方法干预组:某院2012年9月—2013年3月收治的146例口腔癌患者,同期在其围手术期加强实施针对预防下呼吸道感染的综合干预措施;对照组:该院2012年3—8月收治的140例口腔癌患者,执行一般诊疗护理常规,比较两组患者术后下呼吸道感染情况。结果干预组患者术后床头抬高30°、术前术后使用复方洗必泰含漱液口腔护理、全麻喉镜头高压灭菌、全麻气管插管前手卫生以及雾化吸入庆大霉素5项干预措施的执行率均高于对照组,差异均有统计学意义(均P0.01)。干预组下呼吸道感染率为0.68%(1例),低于对照组的5.71%(8例),差异有统计学意义(χ2=4.39,P0.05)。结论实施综合干预措施,能有效降低口腔癌患者手术后下呼吸道感染率。     

A standardized test to assess the impact of different organic challenges on the antimicrobial activity of antiseptics

This paper presents a suggestion for determining the antimicrobial efficacy of antiseptics in a phase 2/step 1 assay. Emphasis is placed on specific organic challenges to evaluate the efficacy of antiseptics used to rinse the oral cavity, mucous membranes, or wounds for either prophylactic or therapeutic reasons. Basic data are given concerning ready-to-use products based on Poly(1-vinyl-2-pyrrolidone-)iodine-complex (PVP-iodine), chlorhexidine, octenidine, or cetylpyridinium chloride. Hydrogen peroxide (3.0%) was included to assess a product with known limited efficacy only. Using Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Enterococcus faecium, and Candida albicans, a 10(5)-fold reduction can be achieved in 10 min without interfering substances. In the presence of 10% albumin, 10% sheep blood, or 1% mucin, a 10(3)-fold reduction is yielded using products based on PVP-iodine, octenidine, or chlorhexidine. The combination of 4.5% albumin, 4.5% sheep blood, and 1% mucin was the most difficult organic challenge and only the products based on PVP-iodine, octenidine, or chlorhexidine remained active. The cetylpyridinium-based product and hydrogen peroxide were less effective. Based on these data, a proposal for a phase 2/step 1 assay for antiseptics is presented to promote the standardization efforts.     

Efficacy of low-concentration iodophors for germicidal hand washing

The efficacy of iodophor germicides containing different concentrations of available iodine against transient (inoculated) bacteria and the natural hand microflora was compared with chlorhexidine gluconate (2 and 4%) liquid detergent (Hibitane), non-germicidal soap and a tap water rinse. The tap water rinse was ineffective compared with all other treatments. Only 4% chlorhexidine gluconate liquid detergent and iodophor containing 0.75% available iodine were significantly better than the non-germicidal soap for reduction of transient bacteria, Escherichia coli and Pseudomonas fluorescens, that had been inoculated onto hands. These agents also caused a significant reduction in the number of 'natural' microorganisms released from hands after a standard 15 s hand wash. The low-concentration iodophor products and the product containing 2% chlorhexidine gluconate failed to give results significantly better than the non-germicidal control soap. Baird-Parker medium and standard aerobic plate counts were highly correlated (r = 0.82), so that for studies of Gram-negative bacteria inoculated onto hands as a transient microflora, counts on Baird-Parker medium give a reasonable indication of the natural (residual) hand microflora.     

Efficacy of low-concentration iodophors for germicidal hand washing.

The efficacy of iodophor germicides containing different concentrations of available iodine against transient (inoculated) bacteria and the natural hand microflora was compared with chlorhexidine gluconate (2 and 4%) liquid detergent (Hibitane), non-germicidal soap and a tap water rinse. The tap water rinse was ineffective compared with all other treatments. Only 4% chlorhexidine gluconate liquid detergent and iodophor containing 0.75% available iodine were significantly better than the non-germicidal soap for reduction of transient bacteria, Escherichia coli and Pseudomonas fluorescens, that had been inoculated onto hands. These agents also caused a significant reduction in the number of ''natural'' microorganisms released from hands after a standard 15 s hand wash. The low-concentration iodophor products and the product containing 2% chlorhexidine gluconate failed to give results significantly better than the non-germicidal control soap. Baird-Parker medium and standard aerobic plate counts were highly correlated (r = 0.82), so that for studies of Gram-negative bacteria inoculated onto hands as a transient microflora, counts on Baird-Parker medium give a reasonable indication of the natural (residual) hand microflora.     

西吡氯铵联合独一味胶囊对牙龈炎患者炎性因子的影响

目的 探讨西吡氯铵含漱液联合独一味胶囊在牙龈炎患者中的应用效果及对炎性因子的影响.方法 选取2020年6—12月牙龈炎患者126例作为对象,按照随机数字表法分为两组,每组各63例.两组患者均采用正畸治疗,对照组采用西吡氯铵含漱液治疗,观察组联合独一味胶囊治疗,两组均连续治疗1个月,并对患者进行6个月的随访,比较两组牙龈...     

不同浓度氯己定口腔护理液在经口气管插管患者中的应用

目的探讨不同浓度氯己定口腔护理液在经口气管插管患者中的应用效果。方法2012年1月-2013年12月某院综合ICU收治的经口气管插管行机械通气时间＞48 h以上患者,共纳入120例符合条件患者,随机分为3组,每组各40例。使用不同浓度氯己定口腔护理液应用于各组患者：试验组（2%）、对照组Ⅰ（0.2%）、对照组Ⅱ（0.12%）。观察并比较3组患者在口臭、口腔黏膜感染、呼吸机相关肺炎（VAP）发生时间及VAP发病率的差异。结果试验组与对照组Ⅰ、对照组Ⅱ患者的VAP、早发VAP的发病率比较差异有统计学意义（均P＜0.05）;进一步两两比较,对照组Ⅱ患者VAP发病率高于试验组（47.50% VS 20.00%,P=0.009）。结论应用2%氯己定与有效的冲洗加擦拭口腔护理方法可有效降低经口气管插管患者的VAP发病率。     

Randomized controlled trial and meta-analysis of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia.

OBJECTIVE: To determine the effectiveness of oral decontamination with 2% chlorhexidine solution for the prevention of ventilator-associated pneumonia (VAP). DESIGN: Randomized controlled trial and meta-analysis. SETTING: A tertiary care university hospital in Bangkok, Thailand. PARTICIPANTS: Adult patients who received mechanical ventilation and who were hospitalized in intensive care units and general medical wards. METHODS: The patients were randomized to receive oral decontamination with 2% chlorhexidine solution or normal saline solution 4 times per day until their endotracheal tubes were removed. The outcome measures were the development of VAP and oropharyngeal colonization with gram-negative bacilli. Meta-analysis was performed by combining the results of the present study with those from another randomized controlled trial that also used a 2% chlorhexidine formulation for oral decontamination. RESULTS: The characteristics of the patients in the chlorhexidine group (n=102) and the normal saline group (n=105) were not significantly different. The incidence of VAP in the chlorhexidine group was 4.9% (5 of 102), and the incidence in the normal saline group was 11.4% (12 of 105) (P=.08). The rate of VAP in the chlorhexidine group was 7 episodes per 1,000 ventilator-days, and the rate in the normal saline group was 21 episodes per 1,000 ventilator-days (P=.04). Irritation of the oral mucosa was observed in 10 (9.8%) of the patients in the chlorhexidine group and in 1 (0.9%) of the patients in the normal saline group (P=.001). Oropharyngeal colonization with gram-negative bacilli was either reduced or delayed in the chlorhexidine group. Overall mortality of the patients did not differ significantly between the groups. Meta-analysis of 2 randomized controlled trials revealed an overall relative risk of VAP for patients in the chlorhexidine group of 0.53 (95% confidence interval, 0.31-0.90; P=.02). CONCLUSION: Oral decontamination with 2% chlorhexidine solution is an effective and safe method for preventing VAP in patients who receive mechanical ventilation.     

三种袋内冲洗制剂在早期种植体周围炎治疗中的疗效评价

目的对3种袋内冲洗液在早期种植体周围炎治疗中的临床疗效进行比较和评价。方法32例早期种植体周围炎患者龈下刮治术后,实验组分别用0．1％碘氧液、3％双氧水、0．2％洗必泰进行牙周袋内冲洗,术后每周冲洗1次,连续4周;对照组不进行牙周袋内冲洗。术前和术后4周分别检测MPI、GBI和PD。结果术后4周,碘氧液、双氧水、洗必泰及对照组MPI分别降低0．76,0．80,0．73和0．81,降低幅度各组无显著性差异（P〉0．05）;GBI分别降低0．62,0．62,0．67和0．43。IO、HP和CHX组降低幅度大于对照组．差异有显著性（P〈0．05）,其中CHX组与对照组比较（P〈0．01）,但碘氧液、双氧水、洗必泰组间无显著性差异（P〉0．05）。PD分别降低2．09mm,2．02mm,2．12mm和1．98mm,各组间差异均无显著性（P〉0．05）。结论含抗茵成分的袋内冲洗液有助于改善牙周组织的炎症状态,可提高龈下刮治在口腔种植体周围炎中的疗效。     

高效液相色谱法测定消毒剂中的醋酸洗必泰

在C1 8 柱上 ,以乙腈 - 0 0 2mol L磷酸二氢钾水溶液 (pH 2 5) (40∶60 )为流动相 ,用高效液相色谱法测定了消毒剂中的醋酸洗必泰。结果表明 ,当醋酸洗必泰的含量小于 1 0 0g L时 ,吸光度符合比尔定律 ,检测下限为 8mg L ,不同浓度标准溶液的精密度小于 4 0 % ,加标回收率在 99 8%～ 1 1 5 2 %之间。与其它液相色谱法相比 ,该法具有线性范围宽、灵敏度高、分析速度快、流动相简单等特点 ,而与高氯酸滴定法及紫外分光光度法相比 ,该法的干扰小 ,能测定复方制剂中的醋酸洗必泰     

术前快速口腔护理对急诊全麻病人肺部感染的影响

目的探讨普外科急诊全麻病人术前快速口腔护理对预防肺部并发症的影响。方法普外科急诊全麻病人90例,随机分为2组,每组45例。观察组用口腔宝含漱液口腔护理,对照组用生理盐水口腔护理。结果 90例普外科急诊全麻病人术前快速口腔护理,其中观察组45例肺部感染8例占17.8%,对照组45例肺部感染26例,占57.8%。结论手术前使用口腔宝含漱液进行手术前口腔干预,可起到局部抑菌杀菌的作用,对预防全麻手术患者肺部感染起到良好效果。